SynthesisPloS one2020
Accuracy of cytokeratin 18 (M30 and M65) in detecting non-alcoholic steatohepatitis and fibrosis: A systematic review and meta-analysis.
Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Diagnostic Value of Serum Cytokeratin 18 for the Staging of Liver Inflammation and Fibrosis: A Meta-Analysis.Journal of clinical laboratory analysis · 2025Pooled it
- Serum Cytokeratin-18 levels as a prognostic biomarker in advanced liver disease: a comprehensive meta-analysis.Clinical and experimental medicine · 2024Pooled it
- Triple hormone receptor agonist retatrutide for metabolic dysfunction-associated steatotic liver disease: a randomized phase 2a trial.Nature medicine · 2024Trial
- Risk assessment in metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction and alcohol-related liver disease: current approaches and future directions.Clinical and molecular hepatology · 2026Review
- Prospective validation of imaging and serum diagnostic biomarkers of steatohepatitis and fibrosis in MASLD: the LITMUS Imaging Study.Nature medicine · 2026Article
- Regulated necrosis at the crossroads of liver inflammation and cancer development.Nature reviews. Gastroenterology & hepatology · 2026Review
- Evaluation methods of hepatic steatosis: From conventional techniques to emerging biomarkers.World journal of hepatology · 2026Review
- From the Liver to Heart in Nonalcoholic Fatty Liver Disease: Single-Cell and Serum Evidence for Cytokeratin 18 in Predicting Cardiovascular Risk.Cardiovascular therapeutics · 2026Article
- Clinical biomarkers and biosensors for early detection of metabolic dysfunction-associated steatohepatitis (MASH): a translational perspective.Frontiers in bioengineering and biotechnology · 2026Review
- Clinical trial design, biomarkers and end points in metabolic and alcohol-related liver disease.Nature reviews. Gastroenterology & hepatology · 2025Review
- Acetyl-CoA Carboxylase Inhibitors for Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Pesticide and Liver Biomarkers Among Ecuadorian Adolescents and Adults Living in Agricultural Settings.Toxics · 2025Article
- Adipokine and Hepatokines in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Current and Developing Trends.Biomedicines · 2025Article
- Usefulness of Endoscopic Ultrasound Strain Elastography for Measuring Liver Stiffness and the Role of Blood Cytokeratin 18 Levels as a Surrogate Marker of Fibrosis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025Article
- Exercise improves surrogate measures of liver histological response in metabolic dysfunction-associated steatotic liver disease.Liver international : official journal of the International Association for the Study of the Liver · 2024Article
- Isoliquiritigenin in combination with visceral adipose tissue and related markers as a predictive tool for nonalcoholic fatty liver disease.Journal of physiology and biochemistry · 2024Article
- Preliminary study on the diagnostic value of LEAP-2 and CK18 in biopsy-proven MAFLD.BMC gastroenterology · 2024Article
- Article
- Serum Cytokeratin 18 Fragment Is an Indicator for Treating Metabolic Dysfunction-Associated Steatotic Liver Disease.Gastro hep advances · 2024Article
- Biomarkers of Hepatic Dysfunction and Cardiovascular Risk.Current cardiology reports · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAssociation between elevated cytokeratin 18 (CK-18) levels and hepatocyte death has made circulating CK-18 a candidate biomarker to differentiate non-alcoholic fatty liver from non-alcoholic steatohepatitis (NASH). Yet studies produced variable diagnostic performance. We aimed to provide summary estimates with increased precision for the accuracy of CK-18 (M30, M65) in detecting NASH and fibrosis among non-alcoholic fatty liver disease (NAFLD) adults.
methodsWe searched five databases to retrieve studies evaluating CK-18 against a liver biopsy in NAFLD adults. Reference screening, data extraction and quality assessment (QUADAS-2) were independently conducted by two authors. Meta-analyses were performed for five groups based on the CK-18 antigens and target conditions, using one of two methods: linear mixed-effects multiple thresholds model or bivariate logit-normal random-effects model.
resultsWe included 41 studies, with data on 5,815 participants. A wide range of disease prevalence was observed. No study reported a pre-defined cut-off. Thirty of 41 studies provided sufficient data for inclusion in any of the meta-analyses. Summary AUC [95% CI] were: 0.75 [0.69-0.82] (M30) and 0.82 [0.69-0.91] (M65) for NASH; 0.73 [0.57-0.85] (M30) for fibrotic NASH; 0.68 (M30) for significant (F2-4) fibrosis; and 0.75 (M30) for advanced (F3-4) fibrosis. Thirteen studies used CK-18 as a component of a multimarker model.
conclusionsFor M30 we found lower diagnostic accuracy to detect NASH compared to previous meta-analyses, indicating a limited ability to act as a stand-alone test, with better performance for M65. Additional external validation studies are needed to obtain credible estimates of the diagnostic accuracy of multimarker models.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.